question
string | options
list | rationale
string | label
string | label_idx
int64 | dataset
string |
|---|---|---|---|---|---|
In presence of Halden effect, CO2 uptake is 2 ml/ 100 ml of blood in aeries, what will be CO2 uptake in absence of Haldone effect in veins ?
|
[
"2 ml/100 ml of blood",
"4 ml/100 ml of blood",
"6 ml/100 ml of blood",
"8 ml/100 ml of blood"
] |
Explanation:
Ans. is 'b' i.e., 4 ml/100 ml of blood
|
b
| 1 |
medmcqa
|
Which of the following statement is false about extended spectrum beta-lactamases (ESBL)?
|
[
"These can hydrolyze penicillins, cephalosporins as well as monobactams",
"Carbapenems are sensitive to ESBL",
"Amber classification of ESBL is based on structural differences",
"Third and fouh generation cephalosporins are used for detection of ESBL,"
] |
Explanation:
Extended-spectrum beta-lactamases (ESBL) are enzymes that confer resistance to most beta-lactam antibiotics, including penicillins, cephalosporins, and the monobactam aztreonam. lmipenem(carbapenem): It is an extremely potent and broad-spectrum Beta-lactam antibiotic whose range of activity includes grampositive cocci, Enterobacteriaceae, Ps. aeruginosa, Listeria as well as anaerobes like Bact. fragilis and Cl. difficile. It is resistant to most Beta-lactamases; inhibits penicillinase producing staphylococci and some MRSA. Extended-spectrum beta-lactamase (ESBL) Members of the family commonly express plasmid encoded b-lactamases (e.g., TEM-1, TEM-2, and SHV-1). which confer resistance to penicillins but not to expanded-spectrum cephalosporins. In the mid-1980s, a new group of enzymes, the extended-spectrum b-lactamases (ESBLs), was detected (first detected in 1979).The prevalence of ESBL-producing bacteria have been gradually increasing in acute care hospitals.ESBLs are beta-lactamases that hydrolyze extended-spectrum cephalosporins with an oxyimino side chain. These cephalosporins include cefotaxime, ceftriaxone, and ceftazidime, as well as the oxyimino-monobactam aztreonam. Thus ESBLs confer multi resistance to these antibiotics and related oxyimino-beta lactams. In typical circumstances, they derive from genes for TEM-1, TEM-2, or SHV-1 by mutations that alter the amino acid configuration around the active site of these b-lactamases. A broader set of b-lactam antibiotics are susceptible to hydrolysis by these enzymes. An increasing number of ESBLs not of TEM or SHV lineage have recently been described.The ESBLs are frequently plasmid encoded. Plasmids responsible for ESBL production frequently carry genes encoding resistance to other drug classes (for example, aminoglycosides). Therefore, antibiotic options in the treatment of ESBL-producing organisms are extremely limited. Carbapenems are the treatment of choice for serious infections due to ESBL-producing organisms, yet carbapenem-resistant (primarily eapenem resistant) isolates have recently been repoed. ESBL-producing organisms may appear susceptible to some extended-spectrum cephalosporins. However, treatment with such antibiotics has been associated with high failure rates. ESSENTIALS OF MEDICAL PHARMACOLOGY, en.wikipedia.org, www.uptodate.com K.D.TRIPATHI SIXTH EDITION PAGE NO:708
|
b
| 1 |
medmcqa
|
The following illnesses are associated with high altitude EXCEPT-
|
[
"Cerebral edema",
"Hypoventilation",
"Venous thrombosis",
"Refractory cough"
] |
Explanation:
High-altitude cerebral edema (HACE) is a medical condition in which the brain swells with fluid because of the physiological effects of traveling to a high altitude. It generally appears in patients who have acute mountain sickness and involves disorientation, lethargy, and nausea among other symptoms. Spontaneous vascular thrombosis may occur after a sho climb or prolonged stay at high altitude (HA). Both venous and aerial thrombosis has been repoed in the literature and cause significant morbidity and moality. Diagnosis is often difficult; treatment delayed and postthrombotic sequelae disabling The Khumbu cough, also referred to as the high altitude hack, is a cough caused by the low humidity and temperatures associated with high altitudes. The Khumbu cough is named after the valley that leads up to Mount Everest in Nepal, but the cough itself is not specific to the Everest region. Ref Davidson 23rd edition pg 1085
|
b
| 1 |
medmcqa
|
Which of the following is a characteristic feature of borderline leprosy
|
[
"Extensive glove and stocking anesthesia",
"Inveed saucer shaped lesions",
"Erythema nodosum leprosum",
"Facial lesions"
] |
Explanation:
Ans. b. Inveed saucer shaped lesions Often a single lesion is present surrounded by several smaller ones. Skin and nerves are the only directly affected tissues in BL (Borderline Lepromatous). The skin lesions consist of erythematous macules or plaques. Inveed saucer-shaped annular lesions are characteristic
|
b
| 1 |
medmcqa
|
The control for mastication is normally exercised by
|
[
"Pontine centres",
"Sub cortical centres",
"Cerebellar centres",
"Medulla centres"
] |
b
| 1 |
medmcqa
|
|
Arterial thrombosis is seen in
|
[
"Homocysteinemia",
"Protein S deficiency",
"Protein C deficiency",
"Antithrombin III deficiency"
] |
a
| 0 |
medmcqa
|
|
Schamberg's purpura are seen on ?
|
[
"Face",
"Feet",
"Chest",
"Arms"
] |
Explanation:
Ans. is 'b' i.e., Feet Schamberg's purpura Most common from of pigmented purpura dermatosis (PPD). Puncate purpura macules develop on lower extrimities, paicularly around ankles & pretibial region. Mostly asymptomatic
|
b
| 1 |
medmcqa
|
Which drug can cause thyroid dysfunction is?
|
[
"Amiodarone",
"Ampicillin",
"Ibutilide",
"Acyclovir"
] |
Explanation:
ANSWER: (A) AmiodaroneREF: Goodman and Gillman s 11TH edition, page 1000, CURRENT Medical Diagnosis and treatment Chapter 26. Endocrine DisordersIndirect repeat in June 2010Amiodarone, because of its high iodine content, causes clinically significant Hypothyroidism inabout 8% of patients.ANTITHYROID COMPOUNDSProcess AffectedExamples of InhibitorsActive transport of iodide Complex anionsPerchlorate, Fluoborate, Pertechnetate, ThiocyanateIodination of thyroglobulin ThionamidesPropylthiouracil. Methimazole, Carbimazole Thiocyanate; iodide. Aniline derivatives; sulfonamidesCoupling reactionThionamides; sulfonamidesHormone releaseLithium salts, iodide, lodotyrosineIodothyronine deiodinationNitrotyrosinesPeripheral deiodinationThiouracil derivatives; Amiodarone Oral cholecystographic agentsHormone actionThyroxine analogs; AmiodaroneHormone excretion inactivationInducers of hepatic drug-metabolizing enzymes: phenobarbital, rifampin, carbamazepine, phenytoinBinding in gutCholestyramine
|
a
| 0 |
medmcqa
|
Melanoma staging according to which classification
|
[
"Breslow",
"Clark",
"Both",
"Bethseda"
] |
Explanation:
Both REF: DeVita, Hellman, and Rosenberg's cancer: principles & practice of oncology - 8th edition Page 1908, Schwaz's Principles of Surgery 9th edition Chapter 16. The Skin and Subcutaneous Tissue The most current staging system, from the American Joint Committee on Cancer (AJCC), contains the best method of interpreting clinical information in regard to prognosis of this disease. Historically, the veical thickness of the primary tumor (Breslow thickness) and the anatomic depth of invasion (Clark level) have represented the dominant factors in the T classification. Whereas Clark used the histologic level , Breslow modified the approach to obtain a more reproducible measure of invasion by the use of an ocular micrometer. The lesions were measured from the granular layer of the epidermis or the base of the ulcer to the greatest depth of the tumor (I, 0.75 mm or less; II, 0.76 to 1.5 mm; III, 1.51 to 4.0 mm; IV, 4.0 mm or more). These levels of invasion have been subsequently modified and incorporated in the MCC staging system.
|
c
| 2 |
medmcqa
|
Low bih weight baby is the one whose bih weight is?
|
[
"Less than 1800 g",
"Less than 2000 g",
"Less than 2500 g",
"Less than 3000 g"
] |
Explanation:
Less than 2500 g REF: Nelson essentials of pediatrics, 17th edition Low bih weight (LBW) infants, defined as infants having bih weights of less than 2500 g, represent a dispropoionately large component of the neonatal and infant moality rates. Although bihs of LBW infants make up only about 6% to 7% of all bihs, they account for greater than 70% of neonatal deaths. IUGR is the most common cause of LBW in developing countries, whereas most LBW in infants in developed countries is secondary to prematurity. Very low bih weight (VLBW) infants, weighing less than 1500 g at bih, represent about 1% of all bihs, but account for 50% of neonatal deaths. Compared with infants weighing 2500 g or more, LBW infants are 40 times more likely to die in the neonatal period; VLBW infants have a 200-fold higher risk of neonatal death. Extremely low bih weight, weighing less than 1000 g at bih.
|
c
| 2 |
medmcqa
|
Mikulicz cell and Russell bodies are characterisitic of:
|
[
"Rhinoscleroma",
"Rhinosporidiosis",
"Plasma cell disorder",
"Lethal midline granuloma"
] |
Explanation:
Ans. A. Rhinoscleroma
|
a
| 0 |
medmcqa
|
Adequate Total per capita water for Urban domestic purposes?
|
[
"50-100 Liters",
"100-150 Liters",
"150-200 Liters",
"200-250 Liters"
] |
Explanation:
Ans. is 'c' i.e., 150-200 litresThe basic physiological requirements for drinking water have been estimated at about 2 litres per head per day.A daily supply of 150-200 litres per capita is considered as an adequate supply to meet the needs for all urban domestic purposes.
|
c
| 2 |
medmcqa
|
Vitamin-A solution contains
|
[
"25,000 IU per ml",
"1,00,000 IU per ml",
"50,000 IU per ml",
"2,00,000 IU per ml"
] |
b
| 1 |
medmcqa
|
|
Humoral immunity arises from -
|
[
"T cells",
"B cells",
"Null cell",
"K cell"
] |
Explanation:
Also known as B lymphocytes, are a type of white blood cell of the lymphocyte subtype. They function in the humoral immunity component of the adaptive immune system by secreting antibodies. Additionally, B cells present antigen (they are also classified as professional antigen-presenting cells (APCs)) and secrete cytokines. Reff : Anandhanarayanan &panikers textbook of microbiology 9th edition pg: 131 B cells,
|
b
| 1 |
medmcqa
|
The CSF findings in TB meningitis include –
|
[
"High sugar + low protein",
"Low sugar + high protein and Lymphocytosis",
"High sugar + high chloride",
"Low sugar + high protein and Lymphopenia"
] |
Explanation:
CSF in T meningitis
Low sugar o Predominant cells --> Lymphocytes o Opening pressure is elevated
High protein o Very low chloride
|
b
| 1 |
medmcqa
|
Multifactorial inheritance is most likely to play a role in?
|
[
"Cleft lip",
"Marfan's syndrom",
"Erythroblastis fetalis",
"Down's syndrome"
] |
Explanation:
A quantitative trait locus (QTL) is a section of DNA (the locus) that correlates with variation in a phenotype (the quantitative trait). Usually the QTL is linked to, or contains, the genes that control that phenotype. QTLs are mapped by identifying which molecular markers (such as SNPs or AFLPs) correlate with an observed trait. This is often an early step in identifying and sequencing the actual genes that cause the trait variation. Quantitative traits are phenotypes (characteristics) that vary in degree and can be attributed to polygenic effects, i.e., the product of two or more genes, and their environment.
|
a
| 0 |
medmcqa
|
If the radius of dentinal tubule is halved, the flow rate will decrease by:
|
[
"2 times",
"4 times",
"8 times",
"16 times"
] |
Explanation:
Flow rate is a function of tubule diameter,pulpal pressure difference,viscosity and tubule length.
A two fold reduction which means making it half, results in a 16 fold reduction as per the formula.
|
d
| 3 |
medmcqa
|
All of the following enzymes are increased in myocardial infarction, EXCEPT:
|
[
"LDH",
"CK",
"Isocitrate dehydrogenase",
"Aspaate aminotransferase"
] |
Explanation:
In MI, total LDH activity is increased, while H4 iso-enzymes is increased 5-10 times more. The magnitude of the peak value will be roughly propoional to the size of myocardial infarct. CK value in serum is increased in myocardial infarction. The CK level stas to rise within 3-6 hours of infarction. Therefore CK estimation is very useful to detect early cases. The CK level is not increased in hemolysis or in congestive hea failure and therefore CK has an advantage over LDH. Normal level of AST is 8-20U/L. The level is significantly elevated in Myocardial infarction. Isocitrate dehydrogenase is not elevated in myocardial infarction. Must know: The enzymes routinely elevated in myocardial infarction are: Creatine kinase(CK) Lactate dehydrogenase(LDH) Aspaate aminotransferase(AST) Cardiac troponin I(CTI) and Cardiac troponin T(CTT) Brain Natriuretic peptide(BNP). It is reliable marker of congestive cardiac failure. Ref: Textbook of Biochemistry By DM Vasudevan, 5th Ed Page 54-55
|
c
| 2 |
medmcqa
|
Deletion of one alpha globin gene on one chromosome is best defined as
|
[
"Hb Bas hydrops fetails",
"Alpha thalassemia major",
"Alpha thalassemia trait",
"Alpha thalassemia silent carrier"
] |
Explanation:
Ans. is 'd' i.e., Alpha thalassemia silent carrier
|
d
| 3 |
medmcqa
|
A 28-year-old man who is a singer/songwriter has been experiencing hard times for the past 3 years. He has played at a couple of clubs a night to earn enough to avoid homelessness. He comes to the free clinic because he has noticed that his voice quality has become progressively hoarser over the past year. On physical examination, he is afebrile. There are no palpable masses in the head and neck area. He does not have a cough or significant sputum production, but he has been advised on previous visits to give up smoking. Which of the following is most likely to produce these findings?
|
[
"Croup",
"Epiglottitis",
"Reactive nodule",
"Squamous cell carcinoma"
] |
Explanation:
Reactive nodules (vocal cord polyps, or singer's nodules) occur most often in men who are heavy smokers or who strain their vocal cords. The nodules are generally only a few millimeters in size and have a fibrovascular core covered by hyperplastic and hyperkeratotic squamous epithelium. They are not premalignant. Croup is an acute laryngotracheobronchitis that most often occurs in children and produces airway narrowing with inspiratory stridor. Epiglottitis is an acute inflammatory process that may cause airway obstruction. Squamous cell carcinomas of the pharynx and larynx form irregular, ulcerating masses, are more common in smokers, but generally are seen in individuals older than this patient. Squamous papillomatosis usually first appears in childhood; if it is extensive, it can produce airway obstruction.
|
c
| 2 |
medmcqa
|
Memory T Cells can be identified by using the following marker
|
[
"CD 45 RA",
"CD 45 RB",
"CD 45 RC",
"CD 45 RO"
] |
d
| 3 |
medmcqa
|
|
Drug used in day care anaesthesia -
|
[
"Propofol",
"Enflurane",
"Xenon",
"Thiopentone"
] |
Explanation:
Ans. is 'a' i.e.. PropofolAmbulatory (outpatient'dav caret Anaesthesiao Ambulatory or day care or outpatient anaesthesaia means, patient comes on same day. gets operated and is discharged on the same day. So, the drugs used in outpatient anaesthesia are those which have short duration of action. Anaesthetic techniques and agents ideal for day care surgery arePremedicationo Usually premedication is not used. However in anxious patients, midazolam is the drug of choice, which should be given 1-2 hours before surgery with sip of water by oral route or 30 min. Before surgery by i.m. route. If patient is prone to nausea nad vomiting, dolasetron is the drug of choice. Ondansetron is an alternative.Airwayo Laryngeal mask airway is preferred over intubation.Intravenous anaestheticso Intravenous route is the preferred method for induction. Propofol is the intravenous anaesthetic of choice for induction because of its smooth induction and rapid recovery'. Antiemetic action of propofol is also beneficial ? use of propofol for induction or maintenance of anaesthesia is associated with a reduced incidence of post - operative nausea and vomiting.Inhalational agentso Inhalational anaesthetics are preferred for maintenance. Desflurane (1st choice) and sevoflurane (2nd choice) are agents of choice. These agents are used along with N2O as N2O decreases the requirement of other anaesthetics hence fastening the recovery'. Halothane and isoflurane have largely been replaced by the less soluble desflurane and sevoflurane.Muscle relaxantso Mivacurium is the muscle relaxant of choice because of its short duration of action. Succinylcholine should be avoided as it causes post - operative myalgia. However, if intubation is required, succinylcholine remains the agent of choice.Opioid analgesicso Opioids compounds are frequently administered during anaesthesia to suppress autonomic responses to tracheal intubation and painful (noxious) surgical stimuli. These drugs are also useful supplements to inhaled anaesthetics during maintenance period. Alfentanil is the agent of choice because of rapid onset andshorter duration of action. Remifentanil is emerging as an alternative because of much shorter duration of action. Fentanyl or sufentanil can also be used.
|
a
| 0 |
medmcqa
|
Sublingual salivary glands are drained by 8-20 excretory ducts called:
|
[
"Bartholins duct",
"Ducts of Rivinus",
"Wharton duct",
"Stenson duct"
] |
Explanation:
Sublingual salivary glands are drained by 8 – 20 excretory ducts called the of rivinus. The largest (major) duct of these is called the Bartholins duct.
|
b
| 1 |
medmcqa
|
Uncontrolled flailing of an arm is a symptom of?
|
[
"Amyotrophic lateral sclerosis",
"Lower motor neuron syndrome",
"Dysdiadochokinesias",
"Hemiballismus"
] |
Explanation:
Hemiballismus is associated with a lesion of the sub thalamic nucleus of the motor system. Lesions in this nucleus produce uncontrolled flailing and involuntary movement, especially of the upper extremity. Amyotrophic lateral sclerosis, a disease of the lower motor neurons, produces weakness in skeletal muscles, which may eventually lead to paralysis and muscle atrophy. Athetosis refers to slow writhing movements of the limbs. This finding is characteristic of lesions in areas of the basal ganglia that are not subthalamic.
|
d
| 3 |
medmcqa
|
Reynolds number describes the relationship between all of the following, EXCEPT:
|
[
"Viscosity of fluid",
"Density of fluid",
"Velocity of flow",
"Direction of flow"
] |
Explanation:
Reynolds number (Re) gives a measure of the ratio of ineial forces to viscous forces. Describes the relation between density of the fluid, diameter of the tube, velocity of flow and viscosity of fluid. The higher the value of Re greater the probability of turbulence. When Re is less than 2000 flow is usually not turbulent. When Re is more than 3000 flow is always turbulent.Re = r x V x D ..............u Ref: Ganong's Review of Medical Physiology, 21st Edition, Page 585
|
d
| 3 |
medmcqa
|
Adeno virus causes all except -
|
[
"Hemorrhagic cytitis",
"Diarrhea",
"Respiratory tract infection",
"IMN"
] |
Explanation:
Adenovirus causes pharyngitis,pneumonia,ARD,pharyngeoconjunctival fever,EKC ,acute follivular conjunctivitis,diarrhea and acute hemorrhagic fever. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:482
|
d
| 3 |
medmcqa
|
Pathogenic feature of malignant hypeension is
|
[
"Fibrinoid necrosis",
"Papillary necrosis",
"Hard exudate",
"All"
] |
Explanation:
Fibrinoid necrosis is a specific pattern of irreversible, uncontrolled cell death that occurs when antigen-antibody complexes are deposited in the walls of blood vessels along with fibrin. It is common in the immune-mediated vasculitides which are a result of type III hypersensitivity. Fibrinoid is limited to small blood vessels. Typically, it involves small aeries, . The walls of necrotic vessels or glomeruli are impregnated with Refer robbins 9/e p939
|
a
| 0 |
medmcqa
|
Newborn babies are able to breathe and suck at the same time due to:
|
[
"Wide short tongue",
"Short soft palate",
"High larynx",
"Short pharynx"
] |
Explanation:
c. High larynx(Ref: Nelson's 20/e p, Ghai 8/e p 134-136)Differences between the airway of a young infant, child and adult include:Oral cavity is small in a newborn & totally filled by tongue due to slightly retracted lower jawThe soft palate & epiglottis are in contact at rest, providing an additional valve at the back of the oral cavityInfant larynx has a short funnel shaped lumen, that is disproportionately narrower than that of adultThe larynx and hyoid cartilage are higher in the neck and closer to the base of the epiglottisThis high position enables an infant to use its nasal airway to breathe while sucking
|
c
| 2 |
medmcqa
|
Greater risk of carcinoma of stomach is associated with-
|
[
"Old age",
"Intestinal metaplasisa",
"Cardiac end ulcer",
"Prepyloric ulcer"
] |
Explanation:
Ans. is 'b' i.e., Intestinal metaplasia
|
b
| 1 |
medmcqa
|
Treatment of choice in cold nodule of thyroid
|
[
"Sub-total thyroidectomy",
"I-131",
"Hemithyroidectomy",
"Excision of nodule"
] |
c
| 2 |
medmcqa
|
|
IQ = 35-47; classified according to WHO is
|
[
"Mild mental retardation",
"Moderate mental retardation",
"Severe mental retardation",
"Profound mental retardation"
] |
Explanation:
(Moderate mental retardation) (502- Park 2(fh)WHO gave the following classification of mental retardationMild mental retardationIQ = 50-70Moderate mental retardationIQ = 35-49Severe mental retardationIQ = 20-34Profound mental retardationIQ = Under 20.
|
b
| 1 |
medmcqa
|
Pseudohpyhae are seen in
|
[
"Cryptococcus",
"Candida",
"Rhizopus",
"Mucor"
] |
Explanation:
Candida is a yeast like fungus that produces Pseudohyphae.
|
b
| 1 |
medmcqa
|
a known case of COPD with acute exacerbation of copd is managed in icu following is not true ?
|
[
"NIV is not indicated",
"o2 inhalation",
"salbutamol inhalation",
"iv dexamethasone"
] |
Explanation:
Role of NIV in Treating Acute COPD * Preferred therapy for exacerbations of COPD in the acute setting Respiratory acidosis: * PaCO2?_ 45 mmHg (6.0 kPa) * Aerial pH 7.35 * Improves oxygenation, increases pH, and decreases PaCO2 * Decreases respiratory rate, work of breathing (can help overcome auto-PEEP), and severity of breathlessness - Success rates up to 85% ref : willey 10th ed
|
a
| 0 |
medmcqa
|
Regarding the hip joint, which of the following statements is true ?
|
[
"Retinaculum attaches femur to hip",
"Inferior gluteal nerve supplies the abductors of the hip",
"Capsule is attached to the intertrochanteric line",
"iliopsoas cuses abduction of hip"
] |
Explanation:
Superior gluteal nerve supplies the abductors of the hip-gluteus medius and gluteus minimus. Iliopsoas causes flexion of hip. Capsule is attached to acetabular labrum on hip bone and intertrochanteric line on femur.
|
c
| 2 |
medmcqa
|
Body mass index of a person whose weight is 89 kg and height is 172 cms is:
|
[
"27",
"30",
"33",
"36"
] |
Explanation:
Body mass index : Is an indicator of obesity: where weight is in kilograms and height is in metres . BMI = weight (kg) /height (m2) = 89/1.72x1.72 = 30
|
b
| 1 |
medmcqa
|
Soot in trachea is a sign of?
|
[
"Postmortem burns",
"Cyanide poisoning",
"Antemortem burns",
"CO poisoning"
] |
Explanation:
Soot in external respiratory passages could be due to antemortem or postmortem burn. But if soot is seen deep in trachea, it is a sign of antemortem burn.
|
b
| 1 |
medmcqa
|
Most common site of morgagni hernia is-
|
[
"Left anterior",
"Right posterior",
"Right anterior",
"Left posterior"
] |
Explanation:
Sites of Congenital Hernia
- Posterolateral costo vertebral hernia - (Foramen of Bochdalek) - Most common. More common on left side.
- Retrosternal - (Foramen of Morgagni) - More common on right side
- Posterior hernia - Failure of posterior part development of diaphragm.
- Central hernia - Rupture of fetal membranous diaphragm - Rare. If present, more commonly seen on left side.
- Through esophageal opening.
|
c
| 2 |
medmcqa
|
Benign condyloma is Associated with which condition (SELECT 1 CONDITION)
|
[
"Infection by human papillomavirus (HPV) type 11",
"Infection by HPV type 16",
"Infection by HPV type 18",
"Lichen sclerosus"
] |
Explanation:
Human papillomavirus (HPV), in particular types 16, 18, and 31, has been linked to cervical neoplasia. HPV types 6 and 11 are associated with benign condyloma. Two types of vulvar dystrophies exist: lichen sclerosus and hyperplastic dystrophy. When hyperplastic dystrophy is found to have atypical features, the lesion is thought to be premalignant. Lichen sclerosus is a benign condition that does not develop cellular atypia.
|
a
| 0 |
medmcqa
|
Which of the following is the agent of choice for treating thyrotoxicosis during pregnancy ?
|
[
"Carbimazole",
"Propylthiouracil",
"Methimazole",
"Radioactive I131"
] |
Explanation:
The antithyroid drugs like carbimazole, methimazole crosses the placenta (transplacental passage) and produce fetal hypothyroidism and goiter if the maternal dose is excessive. However, propylthiouracil should be used in early gestation at low doses as its greater protein binding allows less transfer to the foetus. Carbimazole and methimazole are also associated with rare cases of fetal aplasia cutis and other defects, such as choanal atresia. Pregnancy and breast-feeding are absolute contraindications to radioiodine treatment I131. Reference : page 254 Essentials of Medical Pharmacology K D Tripathi 7th edition and page 2297 Harrison's Principles of Internal Medicine 19th edition
|
b
| 1 |
medmcqa
|
"Limey bile" is?
|
[
"Present in the CBD",
"Thin and clear",
"Like toothpaste emulsion in the gall bladder",
"Bacteria rich"
] |
Explanation:
Ans. (c) Like toothpaste emulsion in the gall bladderRef: Harrison 18th ed/2622* It is a complication of chronic cholecystitis.* Calcium salts in the lumen of the gall bladder in sufficient concentration may produce calcium precipitation and diffuse, hazy opacification of bile or a layering effect on plain abdominal radiography.* This so called limey bile or milk of calcium bile, is usually clinically innocuous but cholecystectomy is recommended, especially when it occurs in a hydropic gall bladder.* In the entity called porcelain gall bladder, calcium salt deposition within the wall of a chronically inflamed gall bladder may be detected on the plain abdominal film.
|
c
| 2 |
medmcqa
|
SIADH is associated with which of the following drug?
|
[
"Vincristine",
"Erythromycin",
"5-FU",
"Methotrexate"
] |
Explanation:
Treatment with vincristine is known to cause SIADH. Erythromycin, 5-FU and Methotrexate are not established causes of Syndrome of Inappropriate Antidiuretic Hormone hypersecretion (SIADH). Ref: Harrison's Principles of Internal Medicine, 16th Edition, Page 2102; Drug-Induced Diseases: Prevention, Detection, and Management, 2nd Edition, James E. Tisdale, Chapter 45, Page 887.
|
a
| 0 |
medmcqa
|
Contre-coup injury is a feature of injury to -
|
[
"Brain",
"Stomach",
"Spleen",
"Heart"
] |
a
| 0 |
medmcqa
|
|
Appearance of which of the following correlates with high levels of hepatitis B virus replication -
|
[
"HBsAg",
"HBeAg",
"Anti HBc",
"IgM Anti HBc"
] |
Explanation:
Ans. is 'b' i.e., HBeAg Serological marker and lab diagnosis* Serological markers for HBV infection are1) HBs Ag (surface antigen or Australia antigen): It is the first marker which appears in the serum. It is the epidemiological marker for HBV infection.2) HBc Ag (core antigen): It is not demonstrable in serum because it is enclosed by HBsAg coat.3) HBe Ag (envelope antigen): It is marker of active replication and high injectivity. It is qualitative marker of replication. HBs Ag carrier mothers who are HBe Ag positive almost invariably (> 90%) transmit hepatitis B infection to their offspring, where as HBs Ag carrier mothers with anti HBe rarely (10 to 15%) infect their offspring.4) Anti-HBc Ag: It is the first antibody appears in serum. IgM anti-HBc Ag is a marker of acute or recent infection. IgG anti-HBc Ag indicates remote infection.5) Anti-HBs Ag: It is protective antibody. It is the only serological marker present after vaccination. After an infection, its presence indicates recovery and end of period of communicability.6) Anti-HBe Ag: Its presence indicate stopage of replication and low infectivity.7) HBV DNA: It is quantitative marker of HBV replication.* HBe Ag - Qualitative marker of replication.* HBV DNA - Quantitative marker of replication. HBs AgAnti HBs AgHBe AgAnti HBe AgAnti HBc AgAcute HBV (high infectivity)+-+ IgMAcute HBV (low infectivity)+- +IgMChronic HBV (high infectivity)+-+ IgMChronic HBV (low infectivity)+- +IgMRecovery-+-+IgMImmunized-+-
|
b
| 1 |
medmcqa
|
In apoptosis, cytochrome C acts through:
|
[
"Apaf 1",
"Bcl-2",
"FADD",
"TNF"
] |
Explanation:
Ans. (a) Apaf 1(Ref Robbins 9th/pg 54-55; 8th/pg 29)Leakage of cytochrome c, other proteins form the inner mitochondrial membrane to cytosol|Cytochrome C binds to APAF-1Q|Activation of caspase-9-critical initiator caspase of the mitochondrial pathway
|
a
| 0 |
medmcqa
|
A child swallow a button battery and on radiological imaging studies it is located in the stomach. Which is the next step in management
|
[
"Endoscopic guided retrieval",
"Open laparotomy and retrieval",
"Emetics and removal of battery",
"Assure and repeat X-Ray after 24 hrs"
] |
Explanation:
Swallowed or inhaled foreign bodies Coins are the most frequently swallowed foreign bodies in children. Once beyond the cardia, they are usually passed in a few days. A plain radiograph of the abdomen, chest and neck should establish the site of radio-opaque objects. Oesophageal objects can be removed endoscopically under general anaesthesia. Button batteries must be removed within hours because if they remain in the oesophagus they can perforate into the trachea or aoa. Batteries in the stomach are either removed urgently or followed very closely with repeat x-rays over a couple of days. The need to remove sharp objects depends on their size, the age of the child and their position in the gut. Ingested magnets can cause entero-enteric fistulae when they fix to one another in adjacent loops of bowel. Battery ingestion in older children and young people may be a manifestation of self-harm. Inhaled foreign bodies cause sudden-onset coughing and stridor. If there is worsening dyspnoea or signs of hypoxia then the infant should be given back blows in a head-down position. Abdominal thrusts (Heimlich manoeuvre) can be used in older children. A foreign body is suggested by: a unilateral wheeze, decreased transmitted breath sounds and a hyperinflated lung from air trapping on an expiratory CXR.A rigid bronchoscopy with a ventilating bronchoscope and appropriate optical forceps is needed to assess and remove objects. Ref: Bailey and love 27th edition Pgno: 132
|
a
| 0 |
medmcqa
|
A normotensive patient with normal hemoglobin suffered massive blood loss. The following findings could be expected, except:
|
[
"Increased PCV",
"Increased MCV",
"Thrombocytosis",
"Reticulocytosis"
] |
Explanation:
PCV in a previously normal patient suffering from massive blood loss is either normal or low. Massive blood loss will result in increased Mean Corpuscular Volume, thrombocytosis and reticulocytosis. In acute blood loss, reticulocytes will increase in blood and reach a maximum level in 7 to 10 days after the hemorrhage is controlled. Packed cell volume (PCV) is a measure of the percentage of red blood cells to the total blood volume and represents the haematocrit. Ref: Harrison's Principles of Internal Medicine, 17th Edition, Page 652; Chaudhury 5th Edition, Page 29 ; Wintrobe's Haematology 11th Edition, Page 975.
|
a
| 0 |
medmcqa
|
Spinal epidural space contains
|
[
"Areolar tissue and internal veebral venous plex uses",
"Only areolar tissue",
"Only cerebrospinal fluid",
"Veebral venous plexus and cerebrospinal fluid"
] |
Explanation:
Epidural space This is the interval which seperates the periosteum in the veebral canal from the spinal duramater.The space is filled with loose areolar tissue,semiliquid fat,a network of veins,and the small aeries which supply the structures in the veebral canal. REF.CUNNINGHAM'S MANUAL OF PRACTICAL ANATOMY,Vol.3,PG.193
|
a
| 0 |
medmcqa
|
Which of the following is not a pa of Becks triad?
|
[
"Hopelessness",
"Wohlessness",
"Helplessness",
"Sleeplessness"
] |
Explanation:
Becks triad is the cognitive triad of depression
|
d
| 3 |
medmcqa
|
Branchial cleft anomalies are present at bih or sholy after bih. Which of the following is TRUE about branchial anomaly?
|
[
"Fistulas are more common than cysts",
"For sinuses surgery is not always indicated",
"Cysts present with dysphagia and hoarseness of voice",
"Most commonly due to 2nd branchial remnants"
] |
Explanation:
The usual course of branchial cleft apparatus anomalies is recurrent infection. These masses may present in the neck as a discrete fullness along the anterior border of the sternocleidomastoid. Cysts are more common than fistulas or sinuses. The majority of branchial cleft cysts arise from the second branchial cleft, with the remainder arising from the first branchial cleft. Third and fouh branchial cleft anomalies are very rare. Surgical excision is performed early rather than later to better ensure that excision is complete. Ref: Otolaryngology: The Essentials edited by Allen M. Seiden, 2002, Page 491.
|
d
| 3 |
medmcqa
|
Principal of using Robertson cooked meat broth -
|
[
"Meat kills other bacteria",
"Meat is utilized by anaerobes",
"Content of meat extract utilize O2",
"All of the above"
] |
Explanation:
Ans. is 'c' i.e., Content of meat extract utilize O2 o Commonly used media for anaerobic culture include:i) Robertson cooked meat broth (most commonly used)ii) Thioglycallate brothiii) Willis and Hobb s mediaiv) Neomycin blod agaro Robertson cooked meat (RCM) broth is the most widely used medium in anaerobic culture.o It consists of nutrient broth and pieces of fat-free minced cooked meat of ox heart with a layer of sterile liquid paraffin over it.o Unsaturated fatty acids and even glutathione and cysteine present in the meat extract utilize oxygen for auto-oxidationo The medium before inoculation is usually boiled at SOX in a water bath to make the medium free of oxygeno The media after inoculation and incubation allows the growth of even strict anaerobes and also indicates their saccharolytic or proteolytic activities as meat turned red or black, respectively.
|
c
| 2 |
medmcqa
|
not seen in ACTH deficiency?
|
[
"hyperpigmentation",
"weight loss",
"hyponatremia",
"hypoglycemia"
] |
Explanation:
ACTH Deficiency * Results in hypocoisolism - Malaise , Anorexia , Weight-loss,weakness ; Gastrointestinal disturbances- Nausea , Vomiting ; Hyponatremia , hypoglycemia, hyperkalemia * Pale complexion - Unable to tan or maintain a tan , Not accompanied by hyperpigmentation * No features of mineralocoicoid deficiency - Aldosterone secretion unaffected ref : harrisons 21st ed
|
a
| 0 |
medmcqa
|
HIV sentinel surveillance used to calculate:
|
[
"Detection of high-risk group",
"Prevalence",
"Monitoring disease trend",
"Detection of incidence"
] |
Explanation:
Ans. c. Monitoring disease trend: Park 23/e p433, 21/e p38, 398 style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">HIV sentinel surveillance used to calculate Trend finding.HIV Sentinel surveillance provides essential information to understand the trends and dynamics of HIV epidemic among different risk groups in the country.HIV Sentinel Surveillance (HSS) in IndiaHIV Sentinel Surveillance (HSS) in India, since its inception in 1998, has evolved into a credible and robust system for HIV epidemic monitoring and acclaimed as one of the best in the world.Sentinel surveillance provides essential information to understand the trendsQ and dynamics of HIV epidemic among different risk groups in the countryQ.It aids in refinement of strategies and prioritization of focus for prevention, care and treatment interventions under the National AIDS Control Programme (NACP).HIV estimates of prevalence, incidence and mortality developed based on findings from HIV Sentinel Surveillance enable the programme in assessing the impacts at a macro level.
|
c
| 2 |
medmcqa
|
Which of the following drug is safe during pregnancy?
|
[
"Aminoglycoside",
"Ampiclillin",
"Chloramphenicol",
"Cotrimoxazole"
] |
Explanation:
AMPICILLIN: It is active against all organisms sensitive to PnG; in addition, many gram-negative bacilli, e.g. H. influenzae, E. coli, Proteus, Salmonella and Shigella are inhibited. However, due to widespread use, many of these have developed resistance; usefulness of this antibiotic has decreased considerably. Pharmacokinetics: Ampicillin is not degraded by gastric acid; oral absorption is incomplete but adequate. Food interferes with absorption. It is paly excreted in bile and reabsorbed-enterchepatic circulation occurs. However, primary channel of excretion is kidney, but tubular secretion is slower than for PnG; plasma halflife is 1 hr. COTRIMOXAZOLE: The fixed dose combination of trimethoprim and sulfamethoxazole is called cotrimoxazole. T rimethoprim is a diaminopyrimidine related to the antimalarial drug pyrimethamine which selectively inhibits bacterial dihydrofolate reductase (DHFRase).Trimethoprim adequately crosses blood-brain barrier and placenta, while sulfamethoxazole has a poorer entry. Moreover, trimethoprim is more rapidly absorbed than sulfamethoxazole--concentration ratios may vary with time. AMINOGLYCOSIDE: PRECAUTIONS AND I NTERACTIONS 1. Avoid aminoglycosides during pregnancy: risk of foetal ototoxicity. 2. Avoid concurrent use of other ototoxic drugs, e.g. high ceiling diuretics, minocycline. 3. Avoid concurrent use of other nephrotoxic drugs, e.g. amphotericin B, vancomycin, cyclosporine and cisplatin. 4. Cautious use in patients past middle age and in those with kidney damage. 5. Cautious use of muscle relaxants in patients receiving an aminoglycoside. 6. Do not mix amino glycoside with any drug in the same syringe/infusion bottle. CHLORAMPHENICOL :is rapidly and completehabsorbed after oral ingestion. It is 50-60% bound to plasma proteins and very widely distributed volume of distribution 1 L/kg. It freely penetrate;o serous cavities and blood-brain barrier: CSF concentration is nearly equal to that of unbound drug in plasma. It crosses placenta and is secreted in bile and milk. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:685,700,716,722
|
b
| 1 |
medmcqa
|
All of the following are components of Child Survival and Safe Motherhood Programme except: March 2012
|
[
"Medical termination of pregnancy",
"Advice of food, nutrition and rest",
"Detection and referral of high risk pregnancies",
"Bih spacing"
] |
Explanation:
Ans: A i.e. Medical termination of pregnancy Medical termination of pregnancy has not been mentioned as a component of CSSM programme (1992), though it been stated as a major intervention under RCH (Reproductive and Child Health) programme.
|
a
| 0 |
medmcqa
|
Ketamine produces -
|
[
"Emergence delirium",
"Pain on injection",
"Bronchoconstriction",
"Depression of cardiovascular system"
] |
Explanation:
Ans. is 'a' i.e., Emergence delirium Ketamineo The primary site of action is in the cortex and subcortical areas; not in the reticular activating system (site of action of barbiturates).o It acts on NMDA receptors.o Short duration of action (10-15 minutes) is due to redistribution from brain and blood to other tissues of the body.o Ketamine is different from most other anaesthetic induction agents in that it has significant analgesic action.o Ketamine increases IOT and cerebral metabolism - contraindicated in head injury.o It causes sympathetic stimulation with elevation of HR, CO & BP - contraindicated in hypertension and ischemic heart disease.o It also raises IOT - contraindicated in glaucoma.o It relieves bronchospasm - intravenous anaesthetic of choice in asthmatics (inhalation anaesthetic of choice in asthmatic is halothane).o Injection is not painful (All other inducing agents cause pain on injection).o It is i.v. anaesthetic of choice in children (Sevoflurane is inhalation agent of choice).o Because it causes sympathetic stimulation it is intravenous anaesthetic of choice in patients with shock and hypovolumia.o It has no muscle relaxant property rather muscle tone is increased.o Airway reflexes (pharyngeal and laryngeal) are not depressed -intravenous anaesthetic of choice for emergency anaesthesia (no starvation is required).o Ketamine produces emergence reaction during awakening from anaesthesia - vivid dreaming, illusions, extracorporeal experiences, excitment, confusion, fear and euphoria - contraindicated in psychiatric illness like schizophrenia.
|
a
| 0 |
medmcqa
|
The X-ray collimators commonly used in dentistry include
the following, except
|
[
"Diaphragm collimator",
"Tubular collimator",
"Rectangular collimator",
"Square collimator"
] |
d
| 3 |
medmcqa
|
|
Urine turns dark on standing in: (Repeat)
|
[
"Alkaptonuria",
"Maple syrup urine disease",
"Phenyl ketonuria",
"Acute intermittent porphyria"
] |
Explanation:
Ans: A (Alkaptonuria) Ref: Harrison's Principles of Internal Medicine 18th edition & Harper's illustrated Biochemistry, 28th edition. Chapter 29, pp 254)Explanation:AlkaptonuriaDue to deficiency in homagentisic acid oxidaseResults in the accumulation of homogentisic acidThe illness has three characteristic symptoms;Homogentisicaciduria (the patient's urine contains elevated levels of homogentisic acid, which is oxidized to a dark pigment on standing,Large joint arthritisBlack ochronotic pigmentation of cartilage and collagenous tissue tOochronsis)Diets low in protein--especially in phenylalanine and tyrosine--help reduce the levels of homogentisic acid, and decrease the amount of pigment deposited in body tissues.Although alkaptonuria is not life-threatening, the associated arthritis may be severely crippling.
|
a
| 0 |
medmcqa
|
True statement about medial medullary syndrome?
|
[
"3rd nerve palsy",
"6th nerve palsy",
"I/L 12 th nerve palsy",
"I/L hemiplegia"
] |
Explanation:
C.N. nuclei involved in medial medullary syndrome is Hypoglossal nuclei (XII) Features of Medial Medullary Syndrome resulting from occlusion of the anterior spinal aery. I/L 12th nerve palsy - Tongue muscle palsy. C/L Spastic paralysis (pyramidal tract involved) Dorsal coloumn medial lemniscal system involved so loss of position sense, vibration and fine touch sensation on C/L side.
|
c
| 2 |
medmcqa
|
Which one of the following elements is NOT added in small amount to be used as grain refiners?
|
[
"Iridium",
"Ruthinium",
"Indium",
"Platinum"
] |
d
| 3 |
medmcqa
|
|
The lingual bar connector should be located at least how many millimeters below the gingival margin?
|
[
"2",
"4",
"6",
"8"
] |
b
| 1 |
medmcqa
|
|
Which of these is not a single gene disorder?
|
[
"Mitral Valve Prolapse",
"Hyperophic Obstructive Cardiomyopathy",
"Dilated Cardiomyopathy",
"Arrhythmogenic Right Ventricular Cardiomyopathy"
] |
Explanation:
Familial HCM, AD Mendelian inherited disease in approximately 50% of cases. Greater than 100 mutations have been identified in at least 12 sarcomeric genes with b-myosin heavy chain being most frequently affected, followed by myosin-binding protein C and troponin T. These three genes account for 70% to 80% of all cases of HCM. In Arrhythmogenic right ventricular dysplasia the ventricular wall is severely thinned as a result of myocyte replacement by massive fatty infiltration and lesser amounts of fibrosis.
|
b
| 1 |
medmcqa
|
The sphincter of Oddi regulates flow of bile (and pancreatic juice) into the duodenum. It consists of:
|
[
"2 sphincters",
"3 sphincters",
"4 sphincters",
"5 sphincters"
] |
Explanation:
The human sphincter of Oddi is about 10-15 mm in length, situated within the muscular layer of the media of the duodenum. It consists of three distinct segments: Sphincter choledochus, Sphincter pancreaticus, and Ampullary sphincterThe choledochal sphincter covers the distal end of the intraduodenal pa of the common bile duct before it joins with the pancreatic duct (duct of Wirsung). The pancreatic sphincter is located at the distal end of the pancreatic duct. The ampullary sphincter covers the distal end of both ducts. The term "sphincter of Oddi" refers to all three sphincters. Ref: Nuclear Hepatology: A Textbook of Hepatobiliary Diseases By Gerbail T. Krishnamuhy, Shakuntala Krishnamuhy, 2009, Page 184.
|
b
| 1 |
medmcqa
|
Most common cause of Bronchiolitis is:
|
[
"RSV",
"Adenovirus",
"Hospitalize and treat",
"Mycoplasma"
] |
Explanation:
a. RSV(Ref: Nelson's 20/e p 2044-2047, Ghai 8/e p 381-382Acute bronchiolitisIt is predominantly a viral disease and RSV is responsible for more than 50% of casesOther agents include parainfluenza, adenovirus, rhinovirus, Mycoplasma, human metapneumovirus and bocavirus.
|
a
| 0 |
medmcqa
|
Ectrodactyly is an autosomal dominant trait that causes missing middle fingers (lobster claw malformation). A grandfather and grandson both have ectrodactyly, but the intervening father has normal hands by x-ray. Which of the following terms applies to this family?
|
[
"Incomplete penetrance",
"New mutation",
"Variable expressivity",
"Germinal mosaicism"
] |
Explanation:
Incomplete penetrance applies to a normal individual who is known from the pedigree to have allele responsible for an autosomal dominant trait. Variable expressivity refers to family members who exhibit signs of the autosomal dominant disorder that vary in severity. When this severity seems to worsen with progressive generations, it is called anticipation. A new mutation in the grandson would be extremely unlikely given the affected grandfather. The father could be an example of somatic mosaicism if a back-mutation occurred to allow normal limb development, but there is no reason to suspect mosaicism of his germ cells (germinal mosaicism).
|
a
| 0 |
medmcqa
|
All the following are causes of secondary achalasia except
|
[
"Allgrove's Syndrome",
"Multiple endocrine neoplasia",
"Kala azar",
"Chaga's disease"
] |
Explanation:
Causes of Secondary achalasia:
Triple 'A' or Allgrove's Syndrome
MEN
Chaga's disease
Cancer Invading LES.
|
c
| 2 |
medmcqa
|
Best way to diagnose lower small intestine obstruction?
|
[
"Pain abdomen",
"Multiple air fluid levels",
"Profuse bilious vomiting",
"Feculent vomiting"
] |
Explanation:
Ans. (b) Multiple air fluid levelsRef: Bailey 26th edition, Page 1189* Two views are allowed to diagnose Small intestinal obstruction:# Supine abdominal film# Erect abdominal film* Bailey and Love says:"Erect films are no more advised, only supine films are enough to diagnose obstruction. In cases of doubt -- erect films are taken"Author's note: But we practically depend more on erect film -- if more than 5 air fluid levels are seen we confirm obstruction.* Findings:# Supine film: Gas filled bowel loops# Erect film: Stepladder pattern of air fluid levels# Air fluid levels appear late.# Number of air fluid levels is directly proportional to the degree of obstruction and distance of obstruction, more distal obstruction has more fluid levels.
|
b
| 1 |
medmcqa
|
Drug of choice for dermatitis herpetiformis:
|
[
"Dapsone",
"Rifampicin",
"Ketokonazole",
"Azithromycin"
] |
Explanation:
Ans: (a) DapsoneRef: Katzung/1468* Dermatitis herpetiformis is a chronic blistering skin condition, characterized by blisters filled with a watery fluid.* DH is neither related to nor caused by herpes virus: the name means that it is a skin inflammation having an ap- pearance similar to herpes.* It characterized by intensely itchy, chronic papulove- sicular eruptions, usually distributed symmetrically on extensor surfaces (buttocks, back of neck, scalp, elbows, knees, back, hairline, groin, or face).* Diagnosis is confirmed by a simple blood test for IgA antibodies, and by a skin biopsy in which the pattern of IgA deposits in the dermo-epidermal junction, revealed by direct immunofluorescence.* Treatment: Dapsone is considered as drug of choice for DH.* In case of intolerance to dapsone, other drugs which can be used are: Colchicine, Tetracycline, Sulfapyridine.
|
a
| 0 |
medmcqa
|
During a routine physical examination, a 58-year-old white male is found to have a 6-cm pulsatile mass in his abdomen. Angiography reveals a marked dilation of his aoa distal to his renal aeries. This aneurysm is most likely the result o
|
[
"Atherosclerosis",
"Hypeension",
"Trauma",
"A previous syphilitic infection"
] |
Explanation:
An aneurysm is an abnormal dilation of any vessel. Atherosclerotic aneurysms, the most common type of aoic aneurysms, usually occur distal to the renal aeries and proximal to the bifurcation of the aoa. Many atherosclerotic aneurysms are asymptomatic, but if they rupture they produce sudden, severe abdominal pain, shock, and a risk of death. Prior to rupture, physical examination reveals a pulsatile mass in the abdomen. Trauma may also lead to the formation of dissecting aneurysms Cystic medial necrosis refers to the focal loss of elastic and muscle fibers in the media of vessels and is seen in patients with hypeension, dissecting aneurysms, and Marfan's syndrome Syphilitic aneurysms are caused by obliterative endaeritis of the vasa vasorum of the aoa. These aneurysms are pa of the teiary manifestation of syphilis and become evident 15 to 20 years after persons have contracted the initial infection with Treponema pallidum Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition.
|
a
| 0 |
medmcqa
|
The topical use of following local anesthetic is not recommended?
|
[
"Ligocaine",
"Bupivacaine",
"Cocaine",
"Dibucaine"
] |
Explanation:
Bupivacine cannot be used as surface anesthetic agent Bupivacine is also contraindicated in regional IV anesthesia or Bier&;s block due to fear of cardiac arrhythmia It can be used in peripheral nerve block, epidural and intrathecal routes
|
b
| 1 |
medmcqa
|
All of the following muscle relaxants are metabolized in liver except:
|
[
"Pancuronium",
"Vecuronium",
"Rocuronium",
"Mivacurium"
] |
Explanation:
Mivacurium is metabolized by pseudocholinesterase present in plasma. Two neuromuscular blocker metabolized by pseudocholinesterase- succinyl choline and mivacurium Most aminosteroid metabolized by hepatic and renal pathway. atracurium and cisatracurium are metabolized by Hoffman degradation and nonspecific ester metabolism.
|
d
| 3 |
medmcqa
|
Roentgen is the unit of: March 2010
|
[
"Radioactivity",
"Radiation exposure",
"Absorbed dose",
"None of the above"
] |
Explanation:
Ans. B: Radiation Exposure The curie, named after scientist Marie Curie, is a unit of measurement used to measure how radioactive an object is, or how much radiation it produces. This is done by examining how fast its atoms disintegrate and measuring their disintegration per second. Roentgen, on the other hand, is a radiation unit that indicates how much radiation is present in the air of a specific environment. This is used to show how much radiation may be absorbed by standing in a paicular place for a ceain amount of time. One roentgen of gamma- or X-ray exposure produces approximately 1 rad (0.01 gray) tissue dose. More common than these two are the rad and the rem. These two units can measure any type of ionizing radiation, including alpha, beta, neutron, gamma and "X," and deal with how much radiation is absorbed by objects. Rad stands for "radiation absorbed dose." One rad equals 100 ergs (an energy unit) absorbed by 1 g of material. Rads are used to show how much radiation any object, especially things like metal and stone, has absorbed. Rem (dose equivalent)is a strictly biological measurement, and stands for "roentgen equivalent man," meaning that it is the same essential measurement as a roentgen, only applied to the human body, although this works only with gamma and "X" types of radiation. Rem is used to define limits of exposure for people who work in nuclear power plants. Rem is often divided in millirems and assigned a length of time, such as millirems per hour. Curie/ becquerel is the unit of radioactivity.
|
b
| 1 |
medmcqa
|
Herald patch is seen:
|
[
"Psoriasis",
"Pityriasis rosea",
"Lichen planus",
"Pityriasis rubra pilaris"
] |
Explanation:
Ans: (b) Pityriasis roseaRef: Rook's Textbook of Dermatology, 8th edition, Page 33.78PITYRIASIS ROSACEAAlso known as Gilbert's disease, six-week diseasePapulosquamous disorder with pruritic or asymptomatic lesionsCommon in adolescents and young adultsRisk factorsViral-HHV-6, HHV-7Drugs-Metronidazole, Captopril, GoldInitial 'herald or mother' patch* 1-2 cms oval plaque on trunk followed by daughter patches two weeks laterChristmas tree pattern* along lines of cleavage with a peripheral collarette of scale producing the Hanging curtain sign when stretched.No oral lesions.Self-limiting.OTHER OPTIONSPityriasis rubra pilarisCircumscribed follicular keratosisBranny scaleOrange-red erythemaPalmoplantar keratodermaIf erythroderma develops there will be islands of normal uninvolved skin.Lichen planusViolaceous polygonal pruritic papules more on the flexural aspects.The lesions show minimal scaling,Wickham's striae may be seen,The mucosa may be involved,Hair and nails also can be involved.PsoriasisErythematous plaques with silvery white plaques which are seen more on the extensor aspects.Auspitz sign will be positive.Scalp scaling is commonly seen.Palms and soles may show scaling and Assuring.Nails may be involved.Psoriatic arthropathy may affect the joints.
|
b
| 1 |
medmcqa
|
True about treatment of nocturnal enuresis
|
[
"lmipramine",
"CPZ",
"Alprazolam",
"Haloperidol"
] |
Explanation:
A i.e. Imipramine
|
a
| 0 |
medmcqa
|
Erlen Meyer Flask Deformity is seen in?
|
[
"Osteopetrosis",
"Thalassemia",
"Craniometaphyseal dysplasias",
"All"
] |
Explanation:
Mnemonics for Erlen Meyer Flask Deformity (CHONG) C: craniometaphyseal dysplasias/Pyles disease H: haemoglobinopathies thalassemia sickle cell disease O: osteopetrosis N: Niemann-Pick disease G: Gaucher disease Radiographs showed a nondisplaced fracture and undeubulation of the distal femoral diaphysis -- a condition known as Erlenmeyer-flask deformity.
|
d
| 3 |
medmcqa
|
A different sequence of amino acids having a similar structure of proteins is an example of
|
[
"Divergence",
"Convergence",
"Opportunistic",
"Incidental"
] |
Explanation:
Divergence and convergence are two evolutionary processes by which organisms become adapted to their environments.
Convergence has been defined as the acquisition of morphologically similar traits between distinctly unrelated
organisms.
Convergence occurs at every level of biological organization.
Functional Convergence
This refers to molecules that serve the same function but have no sequence or structural similarity and carry out their function by entirely different mechanisms.
Mechanistic convergence
Mechanistic convergence occurs when the sequence and structure of molecules are very different but the mechanisms by which they act are similar.
Structural Convergence
This refers to molecules with very different amino acid sequences that can assume similar structural motifs, which may carry out similar functions.
Sequence Convergence
In sequence convergence, one or more critical amino acids or an amino acid sequence of two proteins come to resemble each other due to natural selection. (In protein evolution, sequence divergence, rather than sequence convergence is the rule.)
|
b
| 1 |
medmcqa
|
Most common cause of erectile dysfunction: FMGE 10
|
[
"Psychological",
"Drug induced",
"Alcohol",
"Diabetes"
] |
Explanation:
Ans. Psychological
|
a
| 0 |
medmcqa
|
A female has hypopigmented lesion on centre of forehead drug, responsible is:
|
[
"Hydroquinone",
"Mono benzene metabolite of hydroquinone",
"Para tetra butyl catechol",
"Para tetra butyl phenol"
] |
Explanation:
D i.e. Para tetra butyl phenol Dermatology 3/e p. 92; Fitzpatrick's 7/e p-135-145; Rooks 7/e p.17.7-17.37; Roxburgh's 17/e p- 105-109] - Most common cause of air borne contact dermatitis (ABCD) in India is pahenium hysterophorus (congress grass) plantQ - Metal most commonly l/t allergic contact dermatitis (ACD) is nickel (Ni)Q and drug is neomycin. Whereas detergentQ are most common cause of ACD in Indian females. - Para-tetra (p-test)-Butyl phenol formaldehyde glue (resin) on BindiQ is most common cause of ACD or hypopigmentation on centre of forehead in Indian females.
|
d
| 3 |
medmcqa
|
Apheresis is -
|
[
"Selective separation of components of blood",
"Preventing blood transfusion infections",
"Separation of platelets from plasma",
"Isolating organisms from mixed culture"
] |
Explanation:
Answer- A. Selective separation of components of bloodApheresis is the general technique of extracorporeal blood purification whereby one constituent is removed and the remainder is returned to the patient.
|
a
| 0 |
medmcqa
|
Drugs used in attention deficit hyperactive children are all except ?
|
[
"Modafinil",
"Amphetamines",
"Imipramine",
"Methylphenidate"
] |
Explanation:
Ans. is 'c' i.e., Imipramine Drugs used for ADHD CNS Stimulants Methylphenidate (DOC) Dexmethylphenidate Dextroamphetamine or dextroamphetamine amphetamine Modafinil Other drugs Atomoxetine Bupropion Venlafaxine oc-agonists clonidine, guanfacine) Tricyclic antidepressants (e.g. imipramine) and pemoline, previously used to treat ADHD, are no longer recommended because of potential adverse effects on liver function (pemoline) and potential cardiac arrhythmia effects (Tricyclic antidepressants).
|
c
| 2 |
medmcqa
|
Ends of chromosomes replicated by
|
[
"Telomerase",
"Centromere",
"Restriction endonuclease",
"Exonuclease"
] |
Explanation:
Telomerase is responsible for synthesis of and maintenance of telomere length (end of chromosome).
|
a
| 0 |
medmcqa
|
This virus is a single-stranded RNA orthomyxovirus. Annual vaccination is necessary because of antigenic drift and shift.
|
[
"Measles virus",
"Influenza virus",
"Respiratory syncytial virus",
"Parainfluenza virus"
] |
Explanation:
Orthomyxoviruses and paramyxoviruses are RNA viruses that contain a single-stranded RNA genome. The influenza viruses belong to the orthomyxoviruses. They cause acute respiratory tract infections that usually occur in epidemics. Isolated strains of influenza virus are named after the virus type (influenza A, B, or C) as well as the host and location of initial isolation, the year of isolation, and the antigenic designation of the hemagglutinin and neuraminidase. Both the hemagglutinin and neuraminidase are glycoproteins under separate genetic control, and because of this they can and do vary independently. The changes in these antigens are responsible for the antigenic drift characteristic of these viruses. The paramyxoviruses include several important human pathogens (mumps virus, measles virus, respiratory syncytial virus, and parainfluenza virus). Both paramyxoviruses and orthomyxoviruses possess an RNA-dependent RNA polymerase that is a structural component of the virion and produces the initial RNA. Respiratory syncytial viruses (RSV) are not related to the paramyxoviruses. They are 150-nm single-stranded RNA viruses. There are 2 antigen groups, A and B, which play no role in diagnosis and treatment. While the overall mortality is 0.5%, at-risk groups may be 25 to 35% mortality if untreated. Some parainfluenza virus infections (type 3) may be indistinguishable from RSV, but most parainfluenza infections produce a laryngotracheobronchitis known as croup.
|
b
| 1 |
medmcqa
|
Drugs not used in myocardial infarction are ?
|
[
"Inhibitors of platelet aggregation",
"Thrombolytics",
"Anticoagulants",
"Inhibitors of Plasminogen activator"
] |
Explanation:
Ans. is 'd' i.e., Inhibitors of Plasminogen activator Plasminogen activaters (fibrinolytic agent) are used not inhibitors of plasminogen activators.
|
d
| 3 |
medmcqa
|
A 25-year-old footballer is elbowed in the chest by the rival defender during ball possession. Following the chest trauma, the player collapses and dies. The most probable cause of death is:
|
[
"HOCM",
"Commotio Cordis",
"Hemo-thorax",
"Aoic transaction"
] |
Explanation:
Blunt, non-penetrating, often innocent-appearing injuries to the chest may trigger ventricular fibrillation even in absence of ove signs of injury and lead to sudden cardiac death. This syndrome, referred to as Commotio Cordis, occurs most often in adolescents during spoing events (e.g., baseball, hockey, football) and results from an impact to the chest wall overlying the hea during the susceptible phase of repolarization just before the peak of the T wave. Survival depends on prompt defibrillation.
|
b
| 1 |
medmcqa
|
Buffering is maximum when
|
[
"pH = pKa",
"pH > pKa",
"pH < pKa",
"No relation to pKa"
] |
Explanation:
Ans: a (pH = pKa) Ref: Vasudevan 4'k ecU p.346At values close to pKa, the buffer solution resists changes in pH most effectively. Buffering is the tendency of a solution to resist a change in pH more effectively after addition of a strong acid or base tha n does equal volume of water. Solutions of weak acids and their conjugate bases, and vice versa exhibit buffering. Strong acid /bases do not have buffering quality as great as the weak acid/ bases. pKa refers to the pH at which the concentration of acid equals that of base.* At pH = pKa, the solution would contain acid and base in equal amounts, and therefore would resist a change most effectively in either direction.Note:-The effective range of a buffer is one pH unit higher or lower than pKa.
|
a
| 0 |
medmcqa
|
All of the following drugs may be used in the treatment of ulcerative colitis Except -
|
[
"Corticosteroids",
"Azathioprine",
"Sulfasalazine",
"Methotrexate"
] |
Explanation:
Ans. is 'd' i.e.. Methotrexate Methotrexate in ulcerative colitiso Methotrexate has not been shown to be effective for treating active ulcerative colitis or for maintaining remission.Methotrexate in crohn 's diseaseo Methotrexate has been shown to be effective for inducing remission in patients with steroid dependent and steroid refractory' crohn s disease.Asents that may be used for treatment of ulcerative colitis5-ASAGlucocorticoidsAzathioprine and 6 mercaptopurineCyclosporine or TNF alpha therapy (Infliximab).o Tacrolimus is a macro tide antibody that has shown to be effective in adults with steroid dependent or refractory' ulcerative colitis.Drugs used in crohn's diseaseCyclosporine or infliximab6-Mercaptopurine or azathioprineGlucocorticoid IVGlucocorticoid oralGlucocorticoid rectal5-.4S.4 rectal or oral
|
d
| 3 |
medmcqa
|
Male factor is responsible for infeility in how much percentage -
|
[
"5%",
"20%",
"30%",
"50%"
] |
Explanation:
Ans. is'c'i.e., 30% Infeility: Male factor: 30%Tubal, uterine & peritoneal factor: 25%Ovarian factor: 25%Cervical factor: 10%Unexplained factor: 10%
|
c
| 2 |
medmcqa
|
A 20-year-old woman presents with a 2-week history of fever, malaise, and brown-colored urine. She recently visited Mexico. Physical examination reveals jaundice, mild hepatomegaly, and tenderness in the right upper quadrant. The serum bilirubin is 7.8 mg/dL, with 60% in the conjugated form. Serum levels of AST and ALT are markedly elevated (400 and 392 U/L, respectively). Serum albumin and immunoglobulin levels are normal. Serum IgM anti-hepatitis A virus (anti-HAV) is positive. IgG anti-hepatitis B surface antigen (anti-HBsAg) antibodies are positive. Anti-hepatitis C virus antibodies are negative.What is the most likely diagnosis?
|
[
"Acute viral hepatitis A",
"Acute viral hepatitis B",
"Acute viral hepatitis C",
"Autoimmune hepatitis"
] |
Explanation:
HAV RNA Transmitted by the fecal-oral route and may be contracted by contamination of water and food. Never pursues a chronic course, does not have a carrier state, and provides life-long immunity. IgM anti-HAV is identified in acute infections. -The presence of serum IgG anti-HBsAg indicates prior exposure to hepatitis B virus but does not reflect active disease . -Individuals with chronic hepatitis B do not have detectable anti-HBsAg in their blood. -Acute and chronic hepatitis C are ruled out by the negative serology.
|
a
| 0 |
medmcqa
|
Pulsus paradoxus is seen in all except :
|
[
"IPPV",
"COPD",
"Cardiac Temponade",
"Constrictive pericarditis"
] |
Explanation:
Answer is A (IPPV) Pulsus paradoxus is not a feature of IPPV. Pulsus paradoxus may be seen in association with cardiac tamponade, constrictive pericarditis (infrequent) and COPD. Causes of Pulsus Paradoxus 1. Clinical Disease States Cardiac Tamponade (common) Constrictive Pericarditis (Infrequent) Superior vena cava syndrome Obstructive Airway disease (Emphysema) Acute Asthma Pulmonary embolism Hypovolemic shock 2. In the absence of clincal disease Obesity Pregnancy What is Pulsus Paradoxus Normally the aerial pulse volume and aerial blood pressure decreases during inspiration and increases during expiration. Pulsus paradoxus is an aggravation of a normal process and hence also called pulses normalis aggregans. In pulses paradoxus the decrease in systolic aerial pressure during inspiration is accentuated. What then in the paradox: In patients with pericardial tamponade, airway obstruction or superior vena caval obstruction, the decrease in systolic aerial pressure may be so much that the peripheral pulse may completely disappear during inspiration. The paradox is that the hea sounds may still be heard on auscultation over the apex at a time when no pulse is palpable at the radial aery.
|
a
| 0 |
medmcqa
|
The landmark shown here is
|
[
"Nelatons line",
"Tuffier’s line",
"Transpyloric plane",
"Chein’s line"
] |
Explanation:
Tuffiers line is the intercristal line, that crosses either the body of L4 or L4-L5. It is the landmark for spinal anaesthesia.
|
b
| 1 |
medmcqa
|
Korsakoff syndrome true is/are:
|
[
"Can be seen in chronic alcoholics",
"Absence of intellectual decline",
"Chronic amnestic syndrome",
"All of the above"
] |
Explanation:
Korsakoff syndrome is due to thiamine deficiency. Apa from alcoholism, malnutrition can also cause it. Korsakoff syndrome Chronic neurological complication of long term alcohol use a. Amnesia - Anterograde(m/c) > retrograde b. Learning difficulties c. Confabulations Rx = vitamin B1 oral (Thiamine) for 3 to 12 months * only 20% recover with treatment.
|
d
| 3 |
medmcqa
|
The nitrates which can undergo the first-pass metabolism:
|
[
"Nitroglycerine",
"Pentaerythritol tetranitrate",
"Isosorbide dinitrate",
"All of the above"
] |
Explanation:
Organic nitrates are lipid-soluble: well absorbed from buccal mucosa, intestines and skin. Ingested orally, all except isosorbide mononitrate undergo extensive and variable first pass metabolism in liver.They are rapidly denitrated by a glutathione reductase and a mitochondrial aldehyde dehydrogcnase.
Reference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page no 587
|
d
| 3 |
medmcqa
|
Which amino acid is not present in creatine
|
[
"Arginine",
"Methionine",
"Glycine",
"Lysine"
] |
Explanation:
Creatine doesn't contain lysine, other 3 amino acids are part of creatine.
|
d
| 3 |
medmcqa
|
Food reduces the oral bioavailability of the following angiotensin-converting enzyme inhibitors Except:
|
[
"Enalapril",
"Captopril",
"Ramipril",
"Fosinopril"
] |
a
| 0 |
medmcqa
|
|
Hydrolysis of which of the following compounds yield urea?
|
[
"Ornithine",
"Argininosuccinate",
"Aspartate",
"Arginine"
] |
Explanation:
Arginine is an amino acid that is deaminated to form ornithine primarily in the liver as part of the urea cycle. Ornithine, argininosuccinate, aspartate and citrulline are generated in the urea cycle but do not provide free ammonia for urea synthesis.
|
d
| 3 |
medmcqa
|
True regarding Wolfes graft is
|
[
"Uptake of graft is easy",
"Donor site left open to granulate and contract",
"Large grafts could be taken",
"Not useful for cosmetic surgeries"
] |
Explanation:
Wolfes graft is full thickness skin graft. In this donor site will have to be closed primarily or left open to granulate and contract.
|
b
| 1 |
medmcqa
|
Measles is infective for: March 2009
|
[
"One day before and 4 days after rash",
"Four days before and five days after rash",
"Entire incubation period",
"Only during scabs falling"
] |
Explanation:
Ans. B: Four days before and five days after rash Measles/English Measles is spread through respiration (contact with fluids from an infected person's nose and mouth, either directly or through aerosol transmission), and is highly contagious -- 90% of people without immunity sharing a house with an infected person will catch it. The infection has an average incubation period of 14 days (range 6-19 days) and Period of communicability in measles is approximately 4 days before and 5 days after the appearance of the rash. Measles is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses. Symptoms include fever, cough, runny nose, red eyes and a generalized, maculopapular, erythematous rash.
|
b
| 1 |
medmcqa
|
For a patient of Gastric outlet obstruction, the OPD fluid management is -
|
[
"Normal saline",
"Hypeonic saline",
"Na bicarbonate to counteract aciduria",
"Hypotonic saline without potassium"
] |
Explanation:
Ans : 'a' i.e. Normal saline About fluid management of patients with gastric outlet obstruction Schwaz & Sabiston writes Acute treatment of hypokalemic alkalosis includes administration of large amounts of sodium chloride-containing solutions (i.e. Normal saline) and once diuresis is established, potassium is added until the serum potassium level is increased. This will also correct the serum bicarbonate level.
|
a
| 0 |
medmcqa
|
Which is the most common agent responsible for Ca cervix?
|
[
"HPV 16",
"HPV 18",
"HPV 31",
"HPV 33"
] |
Explanation:
HPV 16 is responsible for about 50% of cervical cancer, and is the most common agent responsible for carcinoma cervix. Other HPV strains associated with cervical cancer are HPV 18, 31 and 45. Ref: Textbook of gynecology by D C Dutta 4th edition Page 316, 322; ALCAMOS'S fundamentals of microbiology By Jeffrey C Pommerville page 829; Johns Hopkins Manual of Gynecology and Obstetrics, The, 3rd Edition, chapter 41.
|
a
| 0 |
medmcqa
|
Mondor's disease is -
|
[
"Thrombophlebitis of the Superficial veins of Breast",
"Carcinoma of the breast",
"Premalignant condition of the breast",
"Filariasis of the breast"
] |
Explanation:
Ans. is 'a' i.e., Thrombophlebitis of the Superficial veins of Breast Mondor's diseaseo is thrombophlebitis of the superficial veins of anterior chest wall and breast although it has also been seen in the arm.o Frequently involved veins are1. lateral thoracic vein,2. thoracoepigastric vein3. superficial epigastric veins.o The women may present with acute pain in the lateral asepct of breast or the anterior chest wall. A tender cord-like superficial thrombosed vein is formed and when the skin over the breast is stretched by raising the arm, a narrow shallow subcutaneous groove alongside the cord becomes apparent.
|
a
| 0 |
medmcqa
|
Which of the following cause early onset of rigor mois?
|
[
"Arsenic",
"Pneumonia",
"Hypothermia",
"Strychnine"
] |
Explanation:
Strychnine causes early onset of rigor mois, the rest of the options causes delayed rigor mois.
|
d
| 3 |
medmcqa
|
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